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Abstract
A 41-year-old woman with recurrent urinary tract infections presented with right flank
pain, fever, and anorexia. Physical examination revealed right-sided flank pain and
a right-sided unilateral renal mass. Computed tomography of the abdomen and pelvis
revealed xanthogranulomatous pyelonephritis with perinephric extension. The bear's
paw sign was visualized. The classic radiology triad (unilateral large kidney, renal
pelvis stone, and a nonfunctioning or poorly functioning kidney) was also found on
computed tomographic imaging. She completed a course of antimicrobial therapy and
underwent a nephrectomy. Her post-operative course was uneventful and she was discharged
from the hospital on postoperative day 4.